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Bibliographical entry (without author) : | VBAC: a continuing controversy. ClinOG, 44, p.561 |
Author(s) : | Zinberg |
Year of publication : | 2001 |
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Abstract (English) : | Review of VBAC and ACOG’s stance. Reasons for ACOG’s more aggressive approach to the availability of personnel and facilities: First the risk of uterine rupture is at least 1% and among these ruptures, some possibly catastrophic, the rate of maternal and/or fetal morbidity is 10-25%. Moreover, there is concern that uterine rupture in VBAC is an underreported event, making this approximate 1% risk to be even higher. Second, based on reports from members of ACOG, uterine rupture almost always results in legal action, no matter what the clinical outcome and no matter how excellent the clinical care. "Medical positions on subjects of long term debate often demonstrate shifting, evolving or even cyclic patterns. The VBAC controversy is no exception to this premise. The concept that VBAC is a safe and effective approach for may patients is a well-established fact. This does not mean that it is appropriate for all women contemplating a pregnancy in the presence of a uterine scar. In the case of VBAC, the pendulum may have swung too far and it may be time to return closer to a middle ground. The medical community should not use VBAC as20its principle tool to respond to society’s economic and social concerns about the increasing CS rate rather individual patient safety and the dictates of best evidence-based medical practice should determine the standard. |
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Comments : | Fiche importée de http://www.worldserver.com/turk/birthing/rrvbac2000-4.html avec l’aide de Ken Turkowski, septembre 2005 |
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Author of this record : | Ken Turkowski — 01 Feb 2006 |
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